Utilizing the Digital Era

Disability Insurance Claims; Getting Paid

Getting paid on a life insurnce policy is elementary, unless the insured commits suicide, goes missing, or something else really weird. Disability insurance is much harder to collect on. Here are some basics:

1. BEFORE YOU MAKE A CLAIM: READ YOUR POLICY AND REVIEW YOUR APPLICATION.
Read the definition of disability in your policy to determine whether or not your condition qualifies for benefits.

Have your treating doctor confirm and explain your disability in writing to the insurance company. Almost all policies require that you be under continuing care by a doctor to qualify for disability benefits.

Review the answers you gave on your application. Are they true? Will they conflict with the medical records that your insurance company will obtain? Be sure that if you answered any of the questions incorrectly you have a good explanation. If there is an inconsistency between your application and your medical history as reflected in your doctor's records, it is often because you misunderstood a question on an application, or, your agent told you the insurance company was not interested in minor problems, or, you did not know, at the time you filled out or signed to the truth of your answers that you had a condition that would have required a different answer. If so, be prepared to explain the inconsistency to your insurer during the claims process.

2. YOU MAY NOT BE ABLE TO COLLECT BENEFITS DURING AN INITIAL ELIMINATION PERIOD.
Most disability policies contain an elimination period that requires you to be disabled for a certain period of time before you can collect benefits. The shorter the elimination period, the more expensive the policy. It's like a deductible.

3. FILE A CLAIM AS SOON AS YOU KNOW YOU ARE DISABLED.
It doesn't matter if you won't be eligible for benefits for several months - file your claim promptly upon discovering your disability. The insurance company has the right to know that you are currently disabled and that you will be applying for benefits. A failure to promptly submit a claim can result in the insurance company denying your benefits. Don't give them the excuse to do this.

4. CONFIRM COMMUNICATIONS WITH THE COMPANY IN WRITING
It's okay to speak to the adjuster assigned to your claim over the phone but follow up with a letter documenting whom you spoke to and what was said. When you send notice of your claim to your insurance company make sure to send it by registered mail, return receipt requested. Don't give them an excuse to tell you that they never received notice of your claim or any other important information that you want them to have.

5. KEEP A CLAIM JOURNAL
Keep a running record of every phone conversation, in-person conversation, date, time, name of person spoken to, etc. Write for as long as it takes to clearly explain what transpired. You may think you will remember, but little details can be really important later on and are easily forgotten when you are under stress.

You have the right to tape record in-person meetings, telephone conversations, and/or insurance company scheduled doctor appointments. Just make sure to tell the adjuster that you are going to do so.